NEARER SCAN (LENO BESIK) evaluation of a task-sharing echocardiographic active case finding programme for rheumatic heart disease in Australia and Timor-Leste: protocol for a hybrid type II effectiveness-implementation study.
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Jones Benjamin, Marangou James, Yan Jennifer, Ralph Anna, Mitchell Alice, Kaethner Alex, Remenyi Bo, Wade Vicki, Katzenellenbogen Judith M, Monteiro Anferida Fernandes, Cannon Jeffrey W, Howard Natasha J, Gilles Marisa, Haynes Emma, Seixas Herculano, Maurays Joaquina, Neave Jade, Pears Chantelle, Engelman Daniel, Canuto Karla, Steer Andrew, Unger Holger, Bailey Meghan, Tanesi Maria, Amaral Salvador, Neto Helder, Stewart Maida, Burgess Paul, Brown Alex, Currie Bart J, Hillis Graham, Morris Peter, Simon David, Wheaton Gavin, Williamson Jacqui, de Dassel Jessica, Slota-Kan Simon, Carapetis Jonathan, English Mike, Nagraj Shobhana, Francis Joshua R
Аннотация
METHODS AND ANALYSIS: Echocardiograms will be obtained by trained local staff using hand-held echocardiographic devices employing the 'Single Parasternal Long Axis view with a Sweep of the Heart' (SPLASH) technique and interpreted by experts remote from the site of acquisition. Approximately 1500 children and pregnant women will be screened across high-risk communities in Australia and Timor-Leste over an 18-month period. The study will use a type II effectiveness-implementation hybrid design. A tailored package of implementation strategies will be co-designed with communities and health services and mapped onto a Theory of Change framework. The clinical effectiveness will be assessed as the change in the proportion of the target population that are prescribed secondary prophylaxis for RHD by the end of the study compared with baseline. The implementation will be assessed as the adoption, penetration, sustainability, fidelity and cost of the programme with a mixed-methods theory-based and economic evaluation. Data will include numbers of normal, abnormal and uninterpretable SPLASH echocardiograms obtained, numbers of participants progressing through the cascade of care, interviews with staff and programme costs.
ETHICS AND DISSEMINATION: Ethical approval has been obtained from the Human Research Ethics Committee of the NT Department of Health and Menzies School of Health Research, Darwin (HREC-2022-4479), the Western Australian Aboriginal Health Ethics Committee (HREC-1237) and the Instituto Nasional Saude Publika Timor-Leste Ethics and Technical Committee (03-UEPD/INSP-TL/V/2023). Informed consent is required to be enrolled. Study findings will be disseminated in the communities involved and submitted for publication.
TRIAL REGISTRATION NUMBER: NCT06002243.